FAQ

OneCare Vermont is committed to make information about the work we do easily available to everyone in a clear, reliable, and easy to understand manner. Toward that end, below is a list of frequently asked questions.

We also welcome specific ideas for additional information to include on this page. Please contact us if you have suggestions.

What is OneCare?

OneCare is Vermont’s local, 501(c)(3) accountable care organization (ACO), partnering with health care providers to transform the state’s health care system from “fee-for-service” to value-based care. OneCare supports participating organizations in their work to deliver excellent health care to Vermonters. Through this partnership, OneCare moves Vermont toward a trusted, equitable health care system where patients and providers work together to achieve optimal health and an exceptional care experience. OneCare for better care.

How is OneCare changing health care?

OneCare Vermont is bringing value-based care to Vermont—changing the way we pay for and deliver care in order to reduce costs and improve the quality of care. The OneCare Vermont model employs three core capabilities: network performance management, data & analytics, and payment reform.

The first step in network performance management to get providers into a value based care model is through the contracts OneCare negotiates on behalf of its member providers. There are currently over 5,000 providers who are members of OneCare Vermont and OneCare negotiates contracts on their behalf with Medicaid, Medicare, and commercial insurers.

Once those contracts are in place, it is then OneCare’s job to help providers succeed. OneCare does this through its additional core capabilities: providing data & analytics on provider’s patient populations and stabilizing costs through OneCare’s innovative payment reform model’s predictable payments.

Provider performance is also supported through the network performance management core capability by: 

  • Adressing social, economic, and physical environment factors that impact health
  • Facilitating care coordination and collaboration in order to deliver the best possible health care to patients
  • Monitoring quality measures to achieve better health outcome

What results is OneCare seeing so far?

As an Accountable Care Organization, OneCare is accountable for both the quality and cost of health care. Each year, health care organizations and providers in OneCare work together to meet quality measures and to achieve shared savings. Organizations participating in OneCare may earn financial incentives for meeting or exceeding quality benchmarks.

OneCare is committed to supporting providers as they work to reach quality targets and achieve shared savings. Read more about our results, quality work plan, and shared savings on our results page. 

How is OneCare governed?

OneCare is governed by a board of managers that makes key financial and operational decisions. Our board is made up of providers from throughout the state and continuum of care, as well as consumers. The list of our current board members can be viewed on the OneCare leadership page. Each board meeting has a session open to the public. Meeting minutes are available here.

What is the overview of the OneCare budget?

OneCare’s 2022 budget was approved by the Green Mountain Care Board (GMCB) on December 22, 2021. The 2022 budget supports the cooperative effort of thousands of providers across Vermont to stabilize health care costs and improve health for Vermonters. To be successful in improving patient experiences and outcomes in 2022, the approved budget makes possible OneCare’s continued support of participating providers in areas such as: data management, monitoring quality, managing and mitigating risk, and working with payers like Medicaid, Medicare, and commercial insurers. Download and view our full 2022 budget presentation on the GMCB website.

What is OneCare's tax status?

OneCare Vermont has always operated as a non-profit in that it budgets to break even each year, however, as a provider-led Accountable Care Organization (ACO) it was required to follow federal ACO program rules which state that 75% of its board include provider representatives whose organizations can receive savings and funding from the ACO. This requirement makes OneCare ineligible for Vermont non-profit status because Vermont law does not allow non-profits to have more than 49% of its board to have a financial interest. In October 2020, OneCare applied to the IRS for federal 501(c)(3) tax status to more accurately reflect our commitment to transparency and value0based reform efforts.

On April 22, 2021, OneCare received notification that it has been recognized by the Federal Government as a 501(c)(3) organization for its commitment to supporting Vermont’s health care delivery and payment reform efforts. This is validation that the federal government believes OneCare meets the charitable purposes of a 501(c)(3) by lessening the government’s burden of healthcare through its partnership in the state of Vermont’s All Payer Model, and by the promotion of health in transition to value-based care, improved supports for primary care delivery, health care innovation, and primary prevention programs.

OneCare Vermont 2020 Form 990

OneCare Vermont is committed to transparency in our service to Vermont in support of the All Payer ACO Model. Submitting our Form 990 is a milestone for OneCare: the first tax return we are filing as a federally recognized not-for-profit 501(c)(3) organization, a designation which reflects our commitment to supporting Vermont’s health care delivery and payment reform efforts. Please note that this is a stub return which covers only the period in 2020 after OneCare filed its 501(c)(3) application with the IRS (October 26, 2020 through December 31, 2020).

Financial Audits

PricewaterhouseCoopers (PwC) audits OneCare’s financials and has given OneCare Vermont a clean audit report for 2017, 2018, 2019, and 2020. Use the links below to access financial audits for OneCare Vermont.

What if I have more questions?

If you have more questions about OneCare, please contact us.